Purple Day for Epilepsy

News

A project to automate lesion detection in drug resistant therapy
may lead to improved treatment for people with epilepsy.
Approximately one-third of epilepsy patients suffer from seizures
that do not respond to drug treatments, making surgery the only
effective treatment for these individuals. More than 90% of
patients enjoy an improved quality of life, seizure-free, once the
brain lesion is removed. Although removing the lesion rarely poses
a problem, finding it does as many times the lesion is tiny and
undetectable. Led by Dr. Andrea Bernasconi, the Neuroimaging of
Epilepsy laboratory at the Montreal Neurological Institute and
Hospital – The Neuro, McGill University, has developed a unique set
of tools that supply a solution based on computer modeling. This
will automatically detect and delineate cortical dysplasia -a
malformation of brain cells present in 70% of severe cases of
epilepsy - on an MRI scan and reproduce the biological character of
the lesion. “Surgery when the MRI fails to reveal obvious cortical
dysplasia is one of the greatest challenges around the world,” says
Dr. Bernasconi who has been working on a solution for the past
eight years. “Our technology is a bit like satellite imagery. Once
the computer zooms in you see all the detail.”

Predicting seizures:

A project to predict seizures in epilepsy led by Dr. Jean Gotman
at The Neuro may allow epileptic sufferers to manage and possibly
prevent seizure. “Epileptic seizures are rarely the big event many
people imagine, says Dr. Gotman. “It’s more likely a disassociation
with your surroundings, maybe a small blackout. One important
problem lies in not knowing when it will happen.” Accurate
prediction could give patients the time to prevent harm: stop a
car, put down a baby or sit down. The team at The Neuro is pursuing
two new paths of investigation. The first follows the team’s
previous work on High Frequency Oscillations (HFOs), tiny
oscillations at 100-500Hz which are very hard to detect. The Neuro
team was recognized in 2006 for developing research on HFOs newly
discovered at University of California, Los Angles. The second
research program uses new sensors to measure local concentrations
of oxygen and pH – a new set of variables under study in patients
with epilepsy. Experimental evidence and clinical observations have
pointed to an increase in oxygen consumption in the seconds or
minutes leading to a seizure.

Epilepsy is a physical condition characterized by sudden, brief
changes in how the brain works. It is a symptom of a neurological
disorder - that affects the brain and shows itself in the form of
seizures

Approximately 1-2% of the Canadian population has epilepsy.
This includes people who take anticonvulsant drugs or who have had
a seizure within the past 5 years.

Each day in Canada, an average of 42 people learn that they
have epilepsy.

A seizure may appear as a brief stare, an unusual movement of
the body, a change in awareness, or a convulsion. A seizure may
last a few seconds or a few minutes.

Epilepsy may result from a variety of causes. These
include:

- Malformations
of brain development

- Head injury
that causes scarring to the brain tissue

- High fever and
prolonged convulsions during early childhood

- Trauma at
birth

- The result of
a stroke or tumor

In almost one third of patients, seizures cannot be controlled
despite the best possible medications. In these patients, surgical
resection of the brain area causing seizures is presently the only
effective treatment in controlling seizures and improving quality
of life.

The Neuro and Epilepsy:

· The Neuro has
been at the forefront of epilepsy treatment and research for three
quarters of a century.

· Dr. Wilder
Penfield and his team developed the “Montreal Procedure,” a
surgical approach that explores the brains of epilepsy patients
while they are awake and under local anesthetic in order to find
the precise tissue causing the seizures and to minimize the risks
of surgery.

· Scientists and
clinicians at The Neuro pioneered the use of EEG to measure brain
activity, and have developed new ways to diagnose and control
epilepsy.

· Today,
scientists at The Neuro study the genetic factors of epilepsy and
epileptic syndromes, use EEG to monitor the electrical
manifestations of epileptic seizures, and also treat the
psychiatric aspects of epilepsy.

· Brain imaging
techniques developed at The Neuro have greatly contributed to the
understanding of causes and consequences of epilepsy. Importantly,
they have facilitated epilepsy surgery by unveiling brain lesions
that are not seen by standard radiological methods.

· The Neuro’s
Epilepsy Clinic sees about 1500 patients per year and provides both
in-patient and out-patient evaluation and treatments.

· The Neuro’s
Epilepsy Program has a multi-disciplinary team that includes
epileptologists, neurosurgeons, nurses, neuropsychologists,
neuropsychiatrists, social workers, EEG technologists, nurse
clinicians and case managers.

· The Epilepsy
team works closely with our community partner Epilepsy Montreal
Metropolitain in providing monthly support group meetings at The
Neuro.

About the Montreal Neurological Institute and
Hospital:

The Montreal Neurological Institute and Hospital -The Neuro-
is a unique academic medical centre dedicated to neuroscience. The
Neuro is a research and teaching institute of McGill University and
forms the basis for the Neuroscience Mission of the McGill
University Health Centre. Founded in 1934 by the renowned Dr.
Wilder Penfield, The Neuro is recognized internationally for
integrating research, compassionate patient care and advanced
training, all key to advances in science and medicine. Neuro
researchers are world leaders in cellular and molecular
neuroscience, brain imaging, cognitive neuroscience and the study
and treatment of epilepsy, multiple sclerosis and neuromuscular
disorders. For more information, please visit www.mni.mcgill.ca.